This $136,900 project aims to develop, deliver, and evaluate hospital outreach intervention for patients with chronic obstructive pulmonary disease (COPD). A randomized controlled trial will be carried out, under which hospitalized COPD patients will be recruited and randomly allocated into control group or intervention group. The latter will receive hospital outreach intervention, which includes 3-month intensive intervention on pulmonary rehabilitation, medication, self-management education, as well as permanent access to a nurse who will promote patients’ treatment adherence through motivational interview and increased communication between patients and health care providers. The evaluation of the trail will be carried out by comparing patients’ self-management, health outcome, quality of life as well as health care cost between the control and treatment groups, based on which recommendations for COPD patient hospital outreach interventions will be made. The study team will develop intervention manuals and employ interviewing techniques to minimize the lack of adherence.